Local residential care homes are performing close to provincial averages but the Office of the Seniors Advocate for British Columbia (OSA) says across-the-board-improvements are needed.
The OSA released results from an extensive survey taken by residents and their visitors in 292 care facilities across the province.
Nearly 10,000 residents took the 108-question survey that looked at how respondents felt about the care they were receiving in areas such as personal control, social life, staff responsiveness, caring staff, food and physician care.
The OSA also looked at more quantifiable things like individual care hours, complaints, number of patients in therapy and medication usage.
While the surveys may not be the best tool for assessing how an individual nursing home measures up due to issues such as small sample size of residents filling out the forms and the subjective manner of many of the questions, Seniors Advocate of BC Isobel Mackenzie thinks they are a great tool for getting an overall picture of how things are across the province.
Locally, 28 out of 61 residents at Castleview Care Centre completed the surveys and 17 out of 60 residents at Talarico Place participated. Residents in palliative care were excluded from participating. Province-wide 42 per cent of residents participated.
The surveys show that care home residents judge their situation differently than someone who isn’t in the same situation might.
“It is a humbling reminder that our assessment of somebody else’s health is from our perspective,” said Mackenzie. “Their perspective is relative. They may think they are in good health, relative to their expectations of what they should feel like. Whereas we are viewing their health from the perspective of the relativity to our own health.”
“One of the things we have to remember is that expectations adjust — everything is relative as we age,” she said.
For Mackenzie, one of the big takeaways of the survey was a reminder of the difficulty of communal living, where people’s expectations are different and what makes them happy is different.
“It’s the same facility, it’s the same food, it’s the same dining room, the same staff, the same activities coordinator — you’ve got somebody who rates things fabulously and somebody who rates things poorly,” she explained.
“Some people are well served and are satisfied — but others are not. So the question is how can we help make it better for those who are not happy.”
Struggles with bathing
One of the negatives that came out of the report was that people were not able to bathe as often as they wanted. The provincial average was that 15 percent said they could “always” bathe as often as they want, 22 per cent said “most of the time,” eight per cent said “sometimes,” 15 per cent said “rarely” and 39 per cent said “never.”
Residents of Talarico Place reported numbers very consistent with the provincial average. Castleview scored a little higher with 46 percent chose “always” or “most of the time” compared to 37 percent provincially and 21 per cent chose “sometimes” and 21 percent chose “never” — almost half of the provincial average.
More help eating needed
The issue of having someone around to help with eating also stood out in the survey with 38 per cent saying they are not reliably getting that help. Castleview scored very close to that number with 36 per cent but Talarico came in at 50 per cent.
Castlegar homes doing better
with toilet assistance
Another area of concern was that 25 per cent of respondents said they couldn’t get help to the toilet when they needed it.
Castleview residents rated their experience much better with only 11 per cent having difficulties. Talarico residents responded even better with no one saying they “rarely” or “never” had problems getting help when needed.
More staff needed
“Those [problems] are all wrapped in we need more staff,” said Mackenzie. “We know we have a shortage of staff in our care homes in B.C. We are not meeting the guideline of 3.36 hours [per patient per day]. We are short about 2.5 million hours overall in the system.”
To be fair to the facilities, it is important to note that individual facilities don’t set their own funding formulas for staff to resident hours. Those are set by the health authorities. Castleview has 3.15 direct care hours per day and Talarico has 3.16. Interior Health funds for 3.15 hours.
A positive outcome of the survey was that 86 per cent of respondents felt they were treated with respect by staff. Locally Castleview came in slightly higher at 88 per cent and Talarico came in even higher at 92 per cent.
Castlegar homes better with anti-
psychotics and therapy
Another quality indicator the OSA looked at (based on actual reporting, not the survey) was the use of antipsychotic medication in patients who have not been diagnosed with psychosis. Both area care facilities are doing much better than the provincial average of 26.9 per cent. Talarico Place has a rate of 20 per cent and Castleview Care Centre only has 12.1 per cent.
Another area that Castlegar facilities are doing well in is the area of residents in either physical, recreation or occupational therapy. The provincial average is 48 per cent. Castleview has 84.7 per cent of residents in therapy and Talarico has 60.2 per cent.
Recommendations
“The overall takeaway is that we need more staffing,” said Mackenzie. “We need to engage — particularly those seniors who still have high levels of function — we need to engage them in a more meaningful way.”
The OSA made several recommendations for system improvements: increasing care hours and ensuring staffing levels are enforced and monitored by health authorities, increasing flexibility of how and when care is delivered, increasing training focused on the emotional needs of residents, expanding the role of nurse practitioners in residential care facilities and increasing the range of activities provided in residential care facilities, particularly in the evenings and weekends.
Individual facility results can be found at bit.ly/2klPkgC.